| LCA CASE NUMBER | I-200-20006-235773 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-01-06 |
| DECISION DATE | 2020-01-13 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-01-13 |
| END DATE | 2023-01-12 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Lutheran Medical Group, LLC |
| EMPLOYER ADDRESS1 | 7916 W. Jefferson Blvd |
| EMPLOYER CITY | Fort Wayne |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46804 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12604346492 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Rexroth |
| EMPLOYER POC FIRST NAME | Nicole |
| EMPLOYER POC JOB TITLE | Chief Operating Officer |
| EMPLOYER POC ADDRESS1 | 7916 W. Jefferson Boulevard |
| EMPLOYER POC CITY | Fort Wayne |
| EMPLOYER POC STATE | IN |
| EMPLOYER POC POSTAL CODE | 46804 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12604346492 |
| EMPLOYER POC EMAIL | nrexroth@lutheran-hosp.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Taub |
| AGENT ATTORNEY FIRST NAME | Elissa |
| AGENT ATTORNEY ADDRESS1 | 1028 Oakhaven Road |
| AGENT ATTORNEY CITY | Memphis |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 38119 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12604346492.0 |
| AGENT ATTORNEY EMAIL ADDRESS | etaub@visalaw.com |
| LAWFIRM NAME BUSINESS NAME | Siskind Susser PC |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | Y |
| SECONDARY ENTITY BUSINESS NAME | Anthony Medical Center |
| WORKSITE ADDRESS1 | 5717 S. Anthony Blvd |
| LCA CASE WORKLOC1 CITY | Fort Wayne |
| WORKSITE COUNTY | ALLEN |
| LCA CASE WORKLOC1 STATE | IN |
| WORKSITE POSTAL CODE | 46806 |
| LCA CASE WAGE RATE FROM | 220000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 135886.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 2.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Schaffler |
| PREPARER FIRST NAME | Macrae |
| PREPARER BUSINESS NAME | Siskind Susser PC |
| PREPARER EMAIL | nrexroth@lutheran-hosp.com |
